Studies on risk factors - RNCE

Registre National des Cancers de l’Enfant

The search for risk factors for childhood cancer is complex. At the time of the diagnosis is made, the determinants that could have intervened very early in fetal life or early childhood to induce cancer are difficult to find retroactively. While we are gradually improving our understanding of the genetic conditions and genetic variants that influence cancer risk, it is much more difficult to retrospectively trace risk factors related to lifestyle, environment or diet, insofar as there is no longer known and objectifiable trace at the time of diagnosis. The rarity of cancers and their diversity add to the complexity of this research.

For this reason, the team uses several complementary approaches, with studies based on interviews with mothers and blood or saliva samples (ESCALE, ESTELLE, MOBI-KIDS studies), studies based solely on knowledge of the municipalities of residence (ecological studies) or on the geolocation of the addresses of patients and controls (GEOCAP, GEOCAP-BIRTH).

The team also works in international consortiums (CLIC, RADONORM) and contributes to the multidisciplinary consortium PEDIAC.


ESCALE and ESTELLE case-control studies

The 2 studies were carried out a few years apart with similar protocols..


The two studies aimed:

  • to study the influence, on the risk of cancer in children, of the course of pregnancy, of the characteristics of the child at birth, of the environment of the child in utero or during childhood , his lifestyle.
  • to identify genetic predisposition factors.
  • to look for possible interactions between genetic factors and environmental factors


The cases were identified in the pediatric oncology departments; the controls were recruited from telephone lists respecting quotas of age, gender and household size.

Case and control mothers were interviewed by telephone.

Blood or saliva samples were taken subject to informed consent.


    ESCALE, 2003-2004    ESTELLE, 2010-2011 
   Interviews  DNA   Interviews   DNA
Leukaemias  764  723  746  707
Lymphomas  295  257  344  317
Brain tumors  209  176  302  254
Neurobastomas  191  154  200  166
Nephroblastomas  -  -  119  106
Hepatoblastomas  -  -  22  19
Controls 1681 810 1421 894


Regulatory aspects

ESCALE   CNIL n°902162 – RBM (DGS 2003/0259)

ESTELLE  CNIL n°908283 – hors RBM -CPP Ile de France IV, 2008/12NICB


ESCALE    Fondation de France, ARC, AFSSAPS, Cent pour Sang la Vie, Inserm, AFSSET, ANR, INCA

ESTELLE  INCa, Ligue Nationale contre le Cancer, Enfants et Santé, DHOS

Principal investigators : Audrey Bonaventure et Jacqueline Clavel


CLIC consortium



This consortium was created in 2007, initially to bring together studies conducted on the etiology of childhood leukemia. Founded by the teams from Berkeley, Montreal and Perth and by our team, the CLIC now brings together 39 researchers from 19 countries and extends to solid tumors. It is coordinated by Logan Spector, Minneapolis.

The EPICEA team contributes to the CLIC through its ESCALE and ESTELLE studies and through 2 previous studies (ADELE and ELECTRE, 1995-1998) devoted to leukemia.

Metayer C, Milne E, Clavel J, Infante-Rivard C, Petridou E, Taylor M, Schüz J, Spector LG, Dockerty JD, Magnani C, Pombo-de-Oliveira MS, Sinnett D, Murphy M, Roman E, Monge P, Ezzat S, Mueller BA, Scheurer ME, Armstrong BK, Birch J, Kaatsch P, Koifman S, Lightfoot T, Bhatti P, Bondy ML, Rudant J, O'Neill K, Miligi L, Dessypris N, Kang AY, Buffler PA. The childhood leukemia international consortium. Cancer Epidemiol 2013:37(3):336-47.

Principal investigators : Audrey Bonaventure et Jacqueline Clavel




The international MOBI-KIDS study aims to assess the potential risk of brain tumors in children and adolescents related to exposure to electromagnetic fields generated by mobile phones and other sources of exposure in their environment.


Mobi-Kids is an international case-control study with hospital recruitment involving 14 countries (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Netherlands, Korea, New Zealand, Spain).

In France, the study took place in 16 departments from 2011 to 2014.

The cases were patients with a primary, benign or malignant brain tumor between 10 and 24 years old.

The controls were patients operated on for appendicitis, matched to the cases on age, sex and département of residence

  • Data collection

The data was collected by face-to-face interviews using a detailed questionnaire covering socio-demographic factors, residential history, the use of mobile phones. On a sample of 20% of cases and controls, the data declared on the time of exposure to mobile phones were confronted with the records of their telephone operators..

Regulatory aspects : CNIL DR-2010-303 et DR-2012-490

Funding : EU FP7, Fondation Santé et Radiofréquences, Fondation Pfizer, INCa, La Ligue

Principal Investigator for : Elizabeth Cardis, IS Global, Barcelone

Principal Investigator for MOBI-KIDS France : Brigitte Lacour

Collaborator for MOBI-KIDS France : Martine Hours, UMRESTTE, UMRT 9405, Lyon




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